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Managing Patients with Insulin Pumps and Continuous Glucose Monitors in the Hospital: to Wear or Not to Wear
Current Diabetes Reports ( IF 5.2 ) Pub Date : 2021-01-15 , DOI: 10.1007/s11892-021-01375-7
Tiffany Yeh , Michele Yeung , Felicia A. Mendelsohn Curanaj

Purpose of Review

As the prevalence of diabetes mellitus in the USA continues to rise, so does the popularity of diabetes management devices such as continuous glucose monitors (CGMs) and insulin pumps. The use of this technology has been shown to improve outpatient glycemic outcomes and quality of life and oftentimes may be continued in the hospital setting. Our aim is to review the current guidelines and available evidence on the continuation of insulin pumps and CGMs in the inpatient setting.

Recent Findings

Patients with diabetes are at higher risk for hospitalizations and complications due to hyper- or hypoglycemia, metabolic co-morbidities, or as seen recently, more severe illness from infections such as SARS-CoV-2. The maintenance of euglycemia is important to decrease both morbidity and mortality in the hospital setting. There is consensus among experts and medical societies that inpatient use of diabetes technology in carefully selected patients with proper institutional protocols is safe and can improve inpatient glycemic outcomes and reduce hypoglycemia. During the COVID-19 pandemic, CGMs played a vital role in managing hyperglycemia in some hospitalized patients.

Summary

Insulin pumps and CGMs have the potential to transform glycemic management in hospitalized patients. In order for institutions to safely and effectively incorporate these technologies on their inpatient units, hospital-based providers will need to be able to understand how to manage and utilize these devices in their practice in conjunction with diabetes experts.



中文翻译:

在医院中使用胰岛素泵和连续血糖监测仪管理患者:佩戴或不佩戴

审查目的

随着美国糖尿病的患病率持续上升,诸如连续血糖监测仪(CGM)和胰岛素泵之类的糖尿病管理设备的普及程度也在不断提高。事实证明,使用该技术可以改善门诊血糖结果和生活质量,并且有时可以在医院中继续使用。我们的目的是回顾住院患者胰岛素泵和CGM持续使用的当前指南和现有证据。

最近的发现

糖尿病患者由于血糖过高或过低,代谢合并症,或者最近因感染严重疾病(例如SARS-CoV-2)而面临住院和并发症的风险更高。维持正常血糖水平对于降低医院的发病率和死亡率都很重要。专家和医学协会之间达成共识,即在经过精心选择的患者中以适当的机构规程住院患者使用糖尿病技术是安全的,并且可以改善住院患者的血糖结果并减少低血糖症。在COVID-19大流行期间,CGM在某些住院患者的高血糖控制中起着至关重要的作用。

概要

胰岛素泵和CGM具有改变住院患者血糖管理的潜力。为了使机构将这些技术安全有效地整合到住院单元中,基于医院的医疗服务提供者将需要能够与糖尿病专家一起了解如何在实践中管理和利用这些设备。

更新日期:2021-01-15
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